人工耳蜗置入后患儿有意义听觉整合量表分数的变化

摘要

BACKGROUND:At present, neither medications nor hearing aids can improve auditory sense of patients with severe sensorineural deafness, and these patients are mostly treated by multi-channel cochlear implantation to restore their auditory sense and promote the development of language ability. OBJECTIVE:To identify the developmental law and influencing factors related to the rehabilitation of language ability in children with severe sensorineural deafness after cochlear implantation and to analyze the correlation of these influencing factors with speech rehabilitation in children. METHODS: Totaly 138 children under 7 years old suffering from severe sensorineural deafness received cochlear implantation. Their auditory sense were accessed using the Meaningful Auditory Integration Scale (MAIS) before and after implantation, and their age, gender, nature of deafness, presence or absence of pre-operative language intervention, age of cochlear implantation, education level of their parents, family economic status, and post-operative rehabilitation approach were analyzed to find a correlation between these factors and their MAIS scores. RESULTS AND CONCLUSION: Gender, length of time after implantation, and development of cochlear showed no effect on MAIS scores of these children (P > 0.05); age of the patient was positively correlated with the MAIS score (P=0), and pre-operative single-ear or double-ear language intervention showed beneficial effect on the MAIS score (P=0.018,P=0), but no significant difference was detected between single-ear and double-ear interventions (P > 0.05); higher family income and higher education level of the parents were correlated with higher MAIS score (P=0,P=0); and those receiving professional in-school rehabilitation training got higher scores than those receiving only family rehabilitation training (P=0). These results suggest that the cochlear implantation significantly improves language development of children with severe sensorineural deafness, and better rehabilitation can be achieved if the child is treated at relatively older age, received pre-operative language intervention, and has a family with high income and parents with higher education level.%背景：目前药物治疗或助听器均不能改善重度或极重度感音神经性耳聋患者的听力，多导人工耳蜗可恢复其听力，促进其言语发育。目的：观察人工耳蜗置入后患儿言语康复的发展规律及影响因素，分析各影响因素与患儿言语康复效果的相关性。方法：选择138例7岁以内重度以上感音神经性耳聋患儿，均接受人工耳蜗置入治疗，于置入前后进行听觉整合量表分数评估，同时分析年龄、性别、耳聋性质、置入前有无言语干预、人工耳蜗置入年龄、置入后时间、父母文化程度、家庭经济状况及置入后康复模式对听觉综合量级测试分数的影响。结果与结论：性别、置入时间长短、耳蜗是否发育正常对患儿有意义听觉整合量表分数无影响(P>0.05)；患儿年龄越大有意义听觉整合量表分数越高(P=0)，置入前进行单耳或双耳言语干预患儿的有意义听觉整合量表分数高于未进行言语干预的患儿(P=0.018，P=0)，但单耳与双耳干预对有意义听觉整合量表分数无影响(P>0.05)；父母文化程度越高、家庭收入越高，患儿有意义听觉整合量表分数越高(P=0，P=0)；接受专业学校教育康复培训患儿的有意义听觉整合量表分数高于家庭教育康复培训的患儿(P=0)。表明人工耳蜗置入可促进患儿听觉言语发育，置入年龄越大、置入前有言语干预、家庭经济收入较高、父母文化程度较高及置入后接受康复训练患儿的言语康复效果越好。